Endocrine Abstracts

Background: Primary hyperaldosteronism (PHA) typically manifests as resistant hypertension, hypokalaemia and metabolic alkalosis. We present a case of PHA who subsequently exposed type 4 renal tubular acidosis (RTA) after surgical intervention.Case history: A 62 year old man underwent investigation for chronic resistant hypertension, which had failed to respond to titration of three antihypertensive agents including Perindopril, Amlodipine and Doxazosin....

A 34-year-old primi gravida, 11 weeks into pregnancy, presented with hypertension (blood pressure 170/110 mmHg) proteinuria and hypokalaemia. She gave a 6-week history of tiredness, weight gain, and easy bruising. On examination, there was marked facial puffiness, non pitting oedema, thin skin with multiple bruises, marked proximal myopathy and no pigmented striae. Pregnancy associated Cushing’s was suspected.Investigations: Hypokalaemia (K+</s...

Background: Neurofibromatosis type 1 (NF1) related Phaeochromocytoma is a rare endocrine disorder and diagnosis is frequently delayed. NF1 is frequently associated with gastro-intestinal stromal tumour but also reported with adenocarcinoma (rare genetic MLH1 mutation). We presented a case where diagnosis of phaeochromocytoma was delayed 5 years after initial symptoms and only incidentally found on scanning at the time of his presentation with colonic...

Background: Neurofibromatosis type 1 (NF1) related Phaeochromocytoma is a rare endocrine disorder and diagnosis is frequently delayed. NF1 is frequently associated with gastro-intestinal stromal tumour but also reported with adenocarcinoma (rare genetic MLH1 mutation). We presented a case where diagnosis of phaeochromocytoma was delayed 5 years after initial symptoms and only incidentally found on scanning at the time of his presentation with colonic...

Background: Adrenal incidentalomas (AI) are asymptomatic adrenal lesions found on imaging not primarily performed to detect adrenal disease. We conducted a retrospective audit of management of AI following European Society of Endocrinology recommendation (2016).Methods: This was a retrospective review of incidentaloma referrals over 9 months (June 2017–March 2018). Cases were identified using criterion search of the referral console. Additional data...

Introduction: Pheochromocytomas (adrenal and extra- adrenal/Paragangliomas) are rare catecholamine producing tumors and required complex dedicated MDTintervention. We preliminarily reported our service in a tertiary referral centre over 10 years (2008–2018).Method: A retrospectively review of confirmed phaeochromocytoma were carried out by reviewing clinical correspondences and ICE investigation-result system (laboratory, radiology and histology.)</...

Phaeochromocytoma during pregnancy is extremely rare with a frequency of 0.002% pregnancies. However, the risks for the pregnant patient with this tumour are extremely high: with maternal and foetal mortality up to 50% if undiagnosed. In contrast, early diagnosis and treatment during pregnancy decrease the maternal and foetal mortality to <5 and 15% respectively.A 37-year-old female underwent abdominal imaging to investigate iron deficiency anaemia. ...

Background: In primary hyperaldosteronism (PHA), CT is the sensitive imaging to visualise adrenal adenoma. However, because of the high incidence of adrenal incidentalomas, adrenal venous sampling (AVS) is frequently required to indentify unilateral (UD) or bilateral (BD) disease. AVS can be technically difficult and result can be operator dependant.Method: We retrospectively reviewed the last 14 cases of AVS performed in our hospital. The criterion of U...

Introduction: Laparoscopic adrenalectomy is the gold standard treatment for adrenal lesions. High volume centres with input from endocrinologists and urologists with a special interest in adrenal lesions may have best outcomes. Aims: To audit our practice and set standards with reference to preoperative workup and postoperative follow-up. This is a single centre, single surgeon experience of surgical adrenalectomy.Material & Method: Over a 10 year pe...

Sub-clinical Cushing’s syndrome has, in recent years, been described among diabetic populations but no consensus has emerged about the value of screening. We enrolled 201 consecutive diabetics attending clinic and 80 controls. Local ethics committee approval was obtained. Patients with at least 2 of the following 3 criteria were offered screening: HbA1c≥7%, BMI≥25 and history of hypertension or BP≥140/90. An 11 pm salivary sample was stored at room tempe...